| NPI | 1598140584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1857531) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 011436) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2018-03-17 |